We carried out a review of the data available to us about Rafael Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rafael Home, you can give feedback on this service.
Rafael Home is a residential care home providing personal care to six people with learning disabilities at the time of the inspection. The service can support up to six people in one adapted building.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received support from staff who were extremely caring, valued people and treated them with respect. Staff demonstrated a high level of empathy, understood people very well and gave priority to the things that were most important to people. Staff used a variety of imaginative methods to support people to express their views and make choices about their care and lifestyle. The service used technology in an innovative way so people could independently complete tasks they would otherwise need staff support for. Staff respected people’s right to privacy and supported them to understand how and when their personal information would be shared, with their agreement.
People’s care and support was highly responsive and tailored to their needs. The provider made adjustments where required to ensure people had equal opportunities to receive care and support that met their needs and to be involved in planning their care. The provider identified people’s needs around end of life care in a person-centred way. People received support to identify and achieve their goals and there were many examples of the positive impact this had had on people’s lives. Staff worked closely with people to make sure they understood the information they received. The provision of activities was exceptionally good and people had many and varied opportunities to pursue their interests, try new things and do their own research into activities they wanted to do. People had the support they needed to maintain relationships with their families and make new friends. Staff supported people to be an active and valued part of their community and practise their religious beliefs. The service was highly responsive to people’s concerns, feedback and complaints.
The service had an empowering culture that promoted respect and inclusion, helped people understand their rights and made people feel valued. People were supported and encouraged to speak up about anything they were unhappy with and their feedback was used to continually improve the service. There was a clear leadership structure and staff understood their roles. There were systems to monitor quality and continually improve the service. This had led to a number of improvements which resulted in the rating being raised from good to outstanding. The provider worked to strengthen the service’s links with the local community to give people better opportunities for social inclusion. The provider worked well in partnership with others and the service was seen as a role model for several areas of good practice.
There were robust processes to protect people from the risk of abuse and to record and learn from incidents. People were safe because risks were assessed and managed in a person-centred way. Staff made sure the home environment was safe and hygienic. Medicines were managed safely. There were enough suitable staff to care for people safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s needs were comprehensively assessed and staff supported people in line with relevant guidance and expert advice. Staff received the support and training they needed to provide effective care. People’s health and nutrition needs were met and staff worked well with healthcare services to provide consistent care. The home environment was suitably decorated and adapted to meet people’s needs.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 5 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last Care Quality Commission (CQC) inspection in July 2015, the overall rating for this service was Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.
People remained safe at the home. Staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. The provider managed risks associated with the premises and equipment well. There were enough staff at the home to meet people’s needs. Recruitment practices remained safe. Medicines continued to be administered safely. The checks we made confirmed that people were receiving their medicines as prescribed by staff qualified to administer medicines.
People continued to be supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people’s needs. We saw that staff encouraged people to make their own decisions and gave them the encouragement, time and support to do so. Staff were providing support in line with the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their needs. People had access to a range of healthcare professionals.
The staff were caring. The atmosphere in the home was calm and friendly. Staff took their time and gave people encouragement whilst supporting them. Throughout the inspection we saw that people had the privacy they needed and were treated with dignity and respect by staff.
People’s needs were assessed before they stayed at the home and support was planned and delivered in response to their needs. People could choose the activities they liked to do. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.
Staff we spoke with described the management as very positive. We observed during our visit that management were approachable and responsive to staff and people’s needs. Systems were in place to monitor and improve the quality of the service. Audits of the premises helped ensure the premises and people were kept safe.
This unannounced inspection took place on 14 July 2015. Although this service has been in existence for many years it had been re-registered on 19 November 2014 to the current provider, Mrs Christine Mouralidarane. This is the first inspection under the new registration.
Rafael Home is a care home which provides accommodation and personal care for up to four people with learning and physical disabilities. There were four people living at the home on the day we visited.
The service had a registered manager at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were safe at the home; people living at the home were happy to speak with us, show us around and answer our questions. The provider took appropriate steps to protect people from abuse, neglect or harm. Staff knew and explained to us what constituted abuse and the action they would take to protect them if they had a concern about a person.
Care plans showed that staff assessed the risks to people's health, safety and welfare. Where risks were identified management plans were in place. Each person had a mobile phone and could call staff or the manager when they wanted to. Staff had taken steps to help keep people safe and support their independence.
The temperature of cooked food was monitored and the fridge and freezer temperatures monitored daily. We saw that the kitchen was visibly clean and the equipment well maintained.
We observed that there were sufficient numbers of qualified staff to care for and support people and to meet their needs. We looked at staff files and saw the correct recruitment process had been carried out to ensure staff employed were suitable for their roles.
People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and audits of medicines conducted. These checks helped to ensure that people were safe from medicines errors.
Staff had the skills, experiences and a good understanding of how to meet people’s needs. People were cared for by staff who received appropriate training and support. Staff meetings were held monthly and one to one supervision took place every eight weeks.
The service had taken appropriate action to ensure the requirements were followed for the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are in place to protect people where they do not have capacity to make decisions and where it is deemed necessary to restrict their freedom in some way, to protect themselves or others. People had the independence and freedom to choose what they did and where they went, in safety with as little restriction on their liberty as possible.
People were supported to eat and drink sufficient amounts to meet their needs. Meals were planned according to people’s wishes and what they said they would like to eat. The food people ate was consistent with people’s dietary needs and religious beliefs.
Detailed records of the care and support people received were kept. Staff took appropriate action to ensure people received the care and support they needed from healthcare professionals.
People were supported by caring staff who had worked at the home for many years and knew the people well. Staff enabled people to make decisions by taking the time to explain things to people and to wait for the person to make a decision.
People’s independence was encouraged. The home held monthly house meetings to discuss future activities, holidays or outings
Staff asked people how they would like to be treated and how they would like their care delivered to help retain their privacy and dignity.
People’s needs were assessed and information from these assessments had been used to plan the care and support they received.
There was an easy read version of the complaints procedure and people told us they felt happy to speak up when necessary.
We could see that people knew who the manager and staff were and could freely chat with them at any time. All the people we spoke with spoke positively about staff and management.
The manager had a good understanding of their management role and responsibilities and the provider’s legal obligations with regard to CQC.
The provider had systems in place to assess and monitor the quality of the service. Weekly, monthly and annual health and safety and quality assurance audits were conducted by the home.